MEDICARE: SHAKYRA D YOUNG PCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	372600000X	Adult Companion
3	3747A0650X	Attendant Care Provider
4	376J00000X	Homemaker
5	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1821643289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAKYRA D YOUNG PCA

Provider Business Mailing Address
First Line	:	500 N RAINBOW BLVD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1061
Country	:	US
Telephone Number	:	702-448-8145
Fax Number	:	702-448-8145

Provider Business Practice Location Address
First Line	:	3710 NAIROBI LN
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89032-9014
Country	:	US
Telephone Number	:	323-458-9833
Fax Number	:	702-448-8145

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2019
Last Update Date	:	08/02/2019

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Directions to “ SHAKYRA D YOUNG PCA” Practice Location

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